Dr. Ahmed Diabetes is one of the leading causes of death, ranked at number 08 according to the World Health Organization.
It has affected a vast number of people globally, and it only grows more prevalent with the passage of time.
While there are multiple medicines prescribed to treat T2DM, a recent group of drugs called GLP-1 RAs and the dual GLP-1/GIP analogs have taken the world by storm.
Since obesity (BMI over 30) is a major risk factor for diabetes, ongoing research is trying to determine which of these meds is most effective in preventing T2DM, especially for those at higher risk.
Obesity – Diabetes: The Vicious Cycle
Obesity is a major risk factor for type 2 diabetes because excess weight can lead to insulin resistance [ref], meaning the cells inside the body become less responsive to the hormone and this can cause blood sugar levels to rise.
However, the relationship between obesity and type 2 diabetes is a bit more complicated than simply having too much weight.
Obesity is one of the strongest risk factors for diabetes. On the other hand, most individuals with type 2 diabetes are overweight.
Visceral fat is associated with insulin resistance which in turn leads to impaired glucose tolerance and diabetes.
Additionally, some dietary habits, such as eating extra amounts of processed items and sugary drinks, can increase the chance of type 2 diabetes as well as obesity.
Tirzepatide and Semaglutide:
Tirzepatide and Semaglutide are slightly different. Tirzepatide is a twincrein. It acts as a GLP-1 and GIP analog.
Semaglutide, on the other hand, is a glucagon-like peptide-1 (GLP-1) receptor agonist. GLP-1 is a hormone made naturally in the body, playing a role in controlling appetite and managing blood sugar levels.
These medications improve insulin sensitivity and promote weight loss. In addition, either because of their weight loss effects and powerful antidiabetic effects, or via direct cellular effects, these drugs have been proven to improve cardiovascular health, kidney, liver, and brain functions.
Tirzepatide is approved by the FDA as Mounjaro and Zepbound. Semaglutide is approved under the brand names of Ozempic, Wegovy, and Rybelsus.
Both Tirzepatide and Semaglutide have been approved for the management of diabetes and weight loss.
Tirzepatide is associated with about 24% body weight loss while Semaglutide is associated with 16% body weight loss.
However, limited data is available as to which drug is best for preventing Type 2 Diabetes and improving cardiovascular mortality.
A study, recently published has addressed this question. The important findings of this study are summarized below:
Methodology:
In this study, they used anonymous electronic medical records from a large database called TriNetX. They gathered the data on June 5, 2024, and created two groups of people: one group without type 2 diabetes (T2D) and another group with T2D.
The study focused on people who started either tirzepatide or semaglutide treatment for the first time and tracked their progress for 12 months after they had been on the treatment for 6 months.
For the first group (without T2DM), the main goal was to see how many had developed T2DM. For the second group (with T2DM), they looked at a combination of serious health issues like death from any cause, stroke, heart attack, and heart failure.
They also checked additional outcomes like changes in blood sugar levels (HbA1c), body weight, and whether people developed other problems like blood vessel damage, suicidal thoughts, or passed away.
To make sure the groups were similar and avoid bias, they matched individuals based on factors like age, weight, health conditions, and other medications they were taking.
This matching helped ensure that any differences in outcomes were likely due to the treatments themselves.
Key Findings: Tirzepatide Vs Semaglutide for Preventing T2DM:
The analysis showed that people taking tirzepatide had a 27% lower risk of developing T2D compared to semaglutide users. Additionally, those on tirzepatide lost more weight, an average of 7.7 kg, compared to 4.8 kg for semaglutide users.
In the group with T2D (8,446 people), those on tirzepatide had a 46% lower risk of experiencing serious health problems like heart attacks or strokes compared to those on semaglutide. Tirzepatide also reduced the risk of stroke by 55% and the risk of death by 67%.
In simple terms, tirzepatide seemed to be more effective than semaglutide in lowering the risk of diabetes and serious heart problems. Nevertheless, the authors have suggested that more studies are needed to confirm these findings in people at high risk for diabetes and heart disease.
Implications for Treatment and Prevention
The results of this study have important effects on how we treat and prevent type 2 diabetes. Tirzepatide and semaglutide might be useful as preventive treatments for people who are at high risk of developing diabetes.
This includes those who are obese, have a family history of diabetes, or have other factors that increase their chances of getting the disease.
In addition, these drugs might provide a better and easier way to manage type 2 diabetes than treatments that came before.
Both Tirzepatide and Semaglutide can help prevent complications related to diabetes, such as heart problems, strokes, kidney issues, and nerve damage, by reducing the risk of developing the disease.
However, it’s needed to recognize that more studies are required to fully understand the long-term benefits and potential risks of these meds.
Moreover, access to these treatments might be restricted because of their cost and availability.
Conclusion
People struggling with diabetes can choose which medicine to go for between semaglutide and tirzepatide because of this study.
Nevertheless, both medicines can properly reduce the chances of developing this chronic condition while also improving the lifestyle of so many people globally.
Moreover, the research is giving other evidence as to why people must address obesity as a key risk factor for type 2 diabetes.
Even though the study has given us some rather important information about the short-term effects of both medicines still we need more research to figure out if the same results come from the long-term effects.
